Lyme Disease: A Case Study

As the clinical lab technician, I have been tapped to determine why a group of 40 patients are experiencing a similar illness and why their current treatments have failed. All of the patients were living in a skilled nursing facility in a rural area, which suffered a tick invasion during a cold winter leading to a Lyme disease outbreak. Lyme disease is a multisystem infectious vector disease propagated by spirochetes of the Borrelia burgodorferi. There are three different manifestations of the disease, which range from acute (erythema migrans), sub-acute (borrelial lymphocytoma), to chronic (acrodermatitis chronica atrophicans) (Mullegger and Glatz). The first cases presented about 6 months ago and only showed physical signs of infection in 10 out of the 40 currently affected patients, with the other 30 remaining

Not everybody who is exposed to Lyme disease presents with this rash, or it may go unnoticed, as is the case with our group of patients. The 10 patients who showed obvious signs of infection were initially tested by the current standard of diagnosis, which is the serologic detection of antibodies against Borrelia burgodorferi, as were the other residents who resided in the facility to determine how widespread the outbreak was. All of the initial tests’ came back negative. This system does however have a limited range in detecting early Lyme disease. The patients with the severe rashes were treated with broad-spectrum antibiotics just for precaution. Had the doctors seen the study performed by Lahey, et al., they could have implemented their 10-antigen panel test, which analyzes surface proteins and synthetic peptides by assessing how they bind with IgG and IgM. The panel identified more samples of early Lyme disease patients than the traditional test (Lahey, et al.). This could have shown that at least a strain of Borrelia was the